The costs of atrial fibrillation in patients with cardiovascular comorbidities-a longitudinal analysis of German health insurance data

Aims Since atrial fibrillation (AFib) is one of the most frequent cardiac disorders, the primary aim of the present study was to assess the disease-related costs as well as the course of costs associated with AFib. The study was focused on a hospitalized patient subgroup with cardiac comorbidities. Methods and results We undertook a retrospective review of the medical, hospital, and drug claims data in the database of a German statutory health insurance company covering similar to 5 million insured persons. The data of patients suffering from AFib were extracted by using documented hospital International Classification of Diseases Revision 10 codes during 2004 and 2005. For these patients we reviewed and summarized all the charges incurred over a 1-year period after the initial index event on the basis of weekly costs and from the third-party payer's perspective. We included 14 798 patients with primary diagnosis of AFib (44.6% male patients, mean age of 72.2+/-10.1 years). The average weekly total first-year cost after AFib was calculated at similar to 148+/-875 Euro per patient. The cumulative total cost was similar to 7688+/-954 Euro per patient for the first year. Thirty per cent of these total costs were directly associated with Afib (2,234+/-838 Euro). Conclusion Atrial fibrillation is associated with significant economic costs from the perspective of statutory health insurance. Since the largest part of costs is attributable to inpatient stays and drug usage, an efficient management of inpatient treatment structures as well as a cost-outcome-oriented drug regime seems to be outstandingly important.